Young People and HIV/AIDS
In 2017 in the United States, youth aged 13 to 24 accounted for more than 1 in 5 new HIV diagnoses. Still, many young people do not think they are personally at risk for HIV.
How is HIV Spread?
People infected with HIV carry the virus in their body fluids, including blood, semen, vaginal secretions, and breast milk. The virus can spread only if these HIV-infected fluids enter the bloodstream of another person. This can take place (1) through the linings of the vagina, rectum, mouth, or the opening at the tip of the penis; (2) through injection with a syringe; or (3) through a break in the skin, such as a cut or sore. The most common ways that people become infected with HIV are:
Unprotected sexual intercourse (either vaginal or anal) with someone who has HIV. The majority of HIV-positive young adults in the U.S. become infected this way.
Sharing needles or syringes (including those used for steroids) with someone who has HIV.
Mother-to-child transmission during pregnancy, childbirth, or breast-feeding. This has declined steeply in the U.S. since the 1990s due to medications that protect infants from infection.
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Are You Afraid You May Already Have HIV?
Some people develop mild, temporary flu-like symptoms or persistent swollen glands immediately after becoming infected with HIV. But symptoms are not a good indicator of HIV infection, because many people don’t experience any symptoms for many years. Even if you look and feel healthy, you could still be infected.
You may be at risk if you have had unprotected sex or if the condom broke during sex, if you have multiple partners or have discovered your partner was not monogamous, if you have shared needles, if you recently tested positive for another sexually transmitted infection, or if you were sexually assaulted. And it is important to know that HIV is more easily passed from men to women or from the insertive partner to the receptive partner among men who have sex with men.
If you think there’s a chance you may have been exposed to HIV, you should get tested as soon as possible.
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What Happens When You Get Tested?
Photo by Wheeler CowperthwaiteWhen HIV enters the bloodstream, it begins to attack certain white blood cells known as CD4 cells. The immune system then produces antibodies to fight off infection. When you take an HIV test, doctors are actually looking for the presence of these antibodies, which confirm that HIV infection has occurred. Some HIV tests look for both antibodies and antigens, which are foreign substances that cause your immune system to activate and are produced even before antibodies develop. Antigen/antibody tests are recommended for testing done in labs and are now common in the United States. There is also a rapid antigen/antibody test available.
Several types of HIV tests are used today. The most common are blood and oral fluid tests. Unlike most testing methods, which can take several days to provide results, rapid HIV testing offers results in 20 minutes to an hour. Although these tests are very accurate, all positive HIV results must be confirmed with a follow-up test before a final diagnosis of infection can be made. If doubts persist, doctors usually recommend a third very sensitive and expensive test that can detect the presence of the virus itself.
Bear in mind—newer antigen-antibody lab tests cannot detect HIV until two to three weeks after exposure to the virus, and it can take three months after the last possible exposure to HIV before a person will test positive with a blood or oral antibody test. Because of this window period, a negative test result does not necessarily rule out HIV infection. Since the virus is most infectious in the earliest weeks after HIV infection, you should take great care to avoid unprotected sex if you think you may have been exposed to HIV. If you have engaged in high-risk sexual activity, it is important to be re-tested every three months.
A positive HIV test result indicates that antibodies to HIV or HIV antigens were detected. It does not mean that you have AIDS or that you will get sick right away. And although there is no cure for HIV/AIDS, currently available drugs are highly effective at keeping the virus in check.
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Where Can You Go to Get Tested?
It's ideal to get tested at a place that provides counseling because counselors can help you understand what your test results mean, answer questions about how to protect yourself and others, and refer you to local HIV-related resources. You can get tested for HIV by your doctor, at local health department clinics, or at hospitals. In addition, many states offer anonymous HIV testing.
It is also possible buy an OraSure rapid oral HIV test over the counter at most pharmacies and test yourself. If you do test positive, you should see your doctor and get a blood test to ensure the result is accurate. To find an HIV testing site near you, visit https://gettested.cdc.gov/, call the Centers for Disease Control and Prevention’s 24-hour toll-free hotline at 800-CDC-INFO (800-232-4636), or text your zip code to KNOW IT (566948).
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Why Is It Important to Know if You’ve Got HIV?
If you think you may have HIV, it is important to find out as soon as possible. HIV is most easily transmitted when the level of virus in the body is at its highest—shortly after HIV infection and at the late stages of the disease. Even in the early stages of HIV infection, you can take concrete steps to protect your long-term health. Beginning medical care before you begin to get sick may give you many more years of healthy life. And knowing you’re HIV positive allows you to take the necessary precautions to prevent others from becoming infected.
If you are HIV positive, it is important to see your doctor regularly. Get tested for tuberculosis and other opportunistic infections. Keep your immune system strong through good nutrition, adequate sleep, and not smoking or drinking alcohol. And find a support system—it is important to remember that you are not alone.
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New HIV Diagnoses Among Youth in the United States, by Race/Ethnicity and Sex, 2016
Subpopulations representing 2% or less of all people who received an HIV diagnosis in 2016 are not represented in this chart.
Source: CDC. NCHHSTP AtlasPlus. Accessed February 2, 2018.
How Can You Tell if Someone Has HIV/AIDS?
You can’t tell if someone has HIV or AIDS simply by looking. An infected person can appear completely healthy. But anyone infected with HIV can infect other people, even if no symptoms are present and even if they believe they are negative. If you are sexually active, the only way to be sure you don’t have HIV is to get tested.
If you’re not sexually active, you’ve already eliminated the most common cause of HIV infection among teens. But if you have made the decision to have sexual intercourse, you need to protect yourself.
HIV/AIDS doesn’t discriminate. That means that anyone who engages in risky behavior can become infected with HIV. But the epidemic has taken an especially heavy toll on some groups of young people, especially African-American and Latino youth, young women, and young men who have sex with men (whether or not they think of themselves as gay).
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When Is Safer Sex Important?
The rules are simple. Whenever you have sexual intercourse (or oral sex), practice safer sex by using a condom or dental dam (a square of latex recommended for use during oral sex). When used properly and consistently, condoms are close to 99% effective in preventing transmission of HIV. But remember:
Use only latex condoms (or dental dams);
Use only water-based lubricants;
Use protection each and every time you have sex.
Other methods of birth control (such as the diaphragm and birth control pills) do not protect against HIV and other sexually transmitted infections (STIs). Practicing safer sex will help you avoid other STIs, many of which can increase your risk of contracting HIV or giving it to someone else. You should also limit the number of sexual partners you have, and limit the use of alcohol or recreational drugs, which can impair judgment during sex.
Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. For more information about PrEP, see https://www.cdc.gov/hiv/risk/prep/index.html.
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Is Protection Necessary During Oral Sex?
While it’s much easier to contract HIV through unprotected vaginal or anal sex, unprotected oral sex is not a completely safe substitute. If you choose to perform or receive oral sex—whether your partner is male or female—it's wise to guard against the transmission of HIV. Here’s how:
Use a latex condom each and every time you perform oral-penile sex (fellatio); or
Use plastic food wrap, a latex condom cut open, or a dental dam during oral-vaginal sex (cunnilingus) or oral-anal sex (analingus).
These methods provide a physical barrier to HIV transmission and help keep you safe from other sexually transmitted infections, many of which can increase your risk of contracting HIV or giving it to someone else.
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Aren’t HIV and AIDS the Same Thing?
HIV (human immunodeficiency virus) causes AIDS (acquired immunodeficiency syndrome). When HIV infects someone, the virus enters the body and begins to multiply and attack the CD4 immune cells that normally protect us from disease. Eventually the body's immune system breaks down and is unable to fight off opportunistic infections and other illnesses ranging from pneumonia and cancer to blindness and dementia. When the CD4 cells fall to a low enough level to make someone with HIV susceptible to these specific infections and illnesses, they are diagnosed with AIDS.
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Is There a Cure for HIV/AIDS?
No effective cure currently exists for HIV. But with proper medical care, HIV can be controlled. Treatment for HIV is called antiretroviral therapy or ART. If people with HIV take ART as prescribed, their viral load (amount of HIV in their blood) can become undetectable. If it stays undetectable, they can live long, healthy lives and have effectively no risk of transmitting HIV to an HIV-negative partner through sex. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS in a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.
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Do STIs Make It Easier to Get HIV?
HIV/AIDS isn’t the only sexually transmitted infection young people have to worry about. The CDC reports that nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017.
Having a sexually transmitted infection can increase your risk of acquiring or transmitting HIV and developing AIDS. This is true whether you have open sores or breaks in the skin (as with syphilis, herpes, and chancroid) or not (as with chlamydia and gonorrhea). Where there are breaks in the skin, HIV can enter and exit the body more easily. But even when you have undamaged skin, STIs can cause biological changes that may make HIV transmission more likely. What to do? Practice safer sex.
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Photo by Kyra Malicse
Can You Get HIV Through Casual Contact?
HIV is not an easy virus to pass from one person to another, like the flu. It is not transmitted through food or air (for instance, by coughing or sneezing). There has never been a case where a person was infected by a household member, relative, co-worker, or friend through casual or everyday contact such as sharing eating utensils and bathroom facilities or hugging and kissing. (Most scientists agree that while HIV transmission through deep or prolonged “French” kissing might be possible, it’s extremely unlikely.) There have been no recorded cases of transmission through contact with saliva, tears, or sweat.
Mosquitoes, fleas, and other insects do not transmit HIV; when they bite a person, they inject their own saliva, not their blood or the blood of the last person they bit. In the U.S., thorough screening of the blood supply for HIV since 1985 has virtually eliminated the risk of infection through blood transfusions. And you can’t get HIV from giving blood at a blood bank or other established blood collection center; they use sterile-packed needles every time they draw blood.
Sources: HIV Among Youth, Basic Statistics: Testing, Basic Statistics: About HIV/AIDS, Sexually Transmitted Diseases, U.S. Centers for Disease Control and Prevention
Last updated September 2018
Top photo: Magnus Fröderberg/norden.org